If you are referring to DJD of the spine, I personally would want to know what portion of the spine is affected.
Once I knew that I would be in a position to determine what is indicated and what is contraindicated.
I am sure you know that DJD is osteoarthritis of the spine. What is important for you to consider, though, is what might be caused as a consequence of DJD. Often DJD results in the narrowing of the verterbral and lateral foramen.
As you know, nerves run through an exit the spine through these foramen. If there is a narrowing, an individual might experience numbness, tingling, or pain. If you are unsure of what you should or should not do, I would proceed with extreme caution because you wouldn’t want to put yourself in a position where an exercise you chose for your client might cause her discomfort.
Hope this gives you a bit of direction.
I do not want to belittle this scary sounding diagnosis but most of us at a beyond-youthful age would probably get that attachment. Check this link http://www.webmd.com/back-pain/tc/degenerative-disc-disease-topic-overvi… to get a little more information.
Since the doctor has cleared her for exercise, I would just use the precautions for anybody with potential lower back problems. Make sure she communicates well with you about anything that causes her discomfort. Since she is in a small group setting, people are sometimes self-conscious about asking for modifications.
Hope this helps.
Being that your client has been cleared for exercise, she needs to focus on three primary categories: 1-Stretching. 2- Stabilization. 3- Core Strengthening.
Stretching is crucial to maintain normal ROM. These stretches should be prescribed by her physician and/or therapist. These stretches should be executed slowly and without any bouncing movement. The stretches she should be performing should include low back, hamstrings, and Psoas Major. Again, her physician should prescribe specific stretches based on her condition.
Stabilization is also very important. Focusing on training the lumbar extensor muscles is most important. Pilates and yoga are great forms of stabilzation exercise because they are performed slowly and in a controlled matter. There are various exercises with medicine balls and balancing machines as well.
Core strengthening is crucial in assisting in any back pain. Strengthening the low back and abdominals.
I also say that you need to know which area of the spine is affected. I have a client who has the same problem in the low back; but, also in the neck.
Decompression work is the best to start off with, then incorporate the strength. I would definitely get a doctor to clear specific exercises and/or programs to keep everyone safe.
Desensitize: The jarring thing needs to be reinforced and made a habit so the client does not make quick moves in a startling situation. You could warn the client that you will be making loud sounds without warning, which is practice to avoid panic/moving suddenly when it happens during their day.